HighlightsLumbar hernia is a rare hernia.Types and etiology of lumbar hernia.Anatomy of the lumbar triangles.Presentation and diagnosis.Management: surgical options.
HighlightsOccult rupture of spleen is a rare occurrence.Various causes for rupture.Rupture in chronic pancreatitis is a rarely reported complication.Diagnosis and management.Pathophysiology and literature review of occult rupture of spleen.
Plasma procalcitonin (PCT) is a highly specific marker for the diagnosis of bacterial infection and sepsis. Studies have demonstrated its role in the setting of sepsis and acute pancreatitis. This study aims to analyze and compare the prognostic efficacy of plasma procalcitonin strip test in acute pancreatitis. A prospective study was conducted in the department of general surgery from June 2012 to June 2013. Plasma procalcitonin was estimated by the semiquantitative strip test. The study included a total of 50 patients diagnosed to have acute pancreatitis. Data was collected and statistically analyzed using SPSS version 17. Thirty-nine out of the 50 patients (78 %) were males with a mean age of 46.8 years (range, 25-78 years) and 25 patients (50 %) had ethanol-induced pancreatitis, while 13 patients (26 %) had gall stone pancreatitis. Plasma PCT values were found to correlate better than CRP levels and total leukocyte count with the total duration of hospitalization, ITU, and ICU stay, as well as with the progression to severe acute pancreatitis. A cut off for plasma PCT of >2 ng/mL was found to be 100 % sensitive and 100 % specific and a cut off for CRP of >19 mg/dL was 70 % sensitive and 65 % specific for predicting the progression to severe acute pancreatitis. Plasma PCT also correlated well with antibiotic requirement. A cut off value of >0.5 ng/mL for plasma PCT was 100 % sensitive and 80 % specific and a cut off value of >18 mg/dL for CRP was 86 % sensitive and 63 % specific for predicting antibiotic requirement. Plasma procalcitonin is an early and reliable prognostic indicator in acute pancreatitis. The procalcitonin strip test is a rapid test which is useful in analyzing prognosis in patients with acute pancreatitis.
Background: Quality of life (QOL) of patients is affected due to procedures done to treat the disease. A good QOL is essential to achieve a holistic approach in treating patients.Methods: We did a cross-sectional study in a tertiary care hospital to describe, identify and compare the factors affecting the QOL of these patients.Results: 42.5% had a permanent stoma and a majority 32.5% were due to a malignancy. Major concerns were skin rash and irritation, depression, loneliness and suicidal thoughts. 62.5% of the total had not gone to work after creation of a stoma. Malignancy was found to be a significant predictor of having a low QOL score.Conclusions: Quality of life of stoma patients in present study was not ideal. There is a definite need to have support groups for these patients in all hospitals.
Plasma PCT (value >5 ng/mL) could be used as an adjunct to clinical examination to predict requirement of surgery in patients presenting with acute abdomen.
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